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Establishing a Managed Care Network for Hepatitis C Justin Schofield Hepatitis C MCN Manager NHS Greater Glasgow & Clyde.

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Presentation on theme: "Establishing a Managed Care Network for Hepatitis C Justin Schofield Hepatitis C MCN Manager NHS Greater Glasgow & Clyde."— Presentation transcript:

1 Establishing a Managed Care Network for Hepatitis C Justin Schofield Hepatitis C MCN Manager NHS Greater Glasgow & Clyde

2  Phase II Action Plan  Evidence  Strategic direction  Investment  Cross-cutting priorities & actions  Hepatitis C MCN  Co-ordinated approach to service development  New ways of working  Improve service to patients  Health Boards & partners  Where to start?  Who to engage with?  How to manage process? Aim: Provide overview of the process for establishing a hepatitis C MCN Content:  MCN core principles  Management arrangements  Identify stakeholders  Map patient journeys  Annual work plan  Service standards  Quality assurance  Risks & potential benefits Introduction

3 Definition  A Managed Care Network is:  A linked group of health professionals & organisations,  working in a co-ordinated manner,  unconstrained by existing professional and organisational boundaries,  to ensure equitable provision of high quality, clinically effective services. Scottish Executive MEL(1999)10

4 1. Management arrangements  Lead Clinician  Network Manager 2. Structure  Patient pathway 3. Annual work plan  Activities  Outputs  Benefits to patients  Annual report 4. Evidence base  SIGN  Clinical audit & research findings  National & local evidence of need 5. Membership  Multi-disciplinary & multi- professional 6. Patients & vol. sector  Supported to enable meaningful participation 7. Quality Assurance  MCN accreditation  Clinical governance, audit, risk management, patient safety 8. Education & training  Continuous professional development  Internal & external to MCN 9. Value for money  Evidence that this has been explored 1: Core principles

5 National Hepatitis C Executive Leads Group (in existence) National Hepatitis C Executive Leads Group (in existence) National Hepatitis C MCN Clinical Leads’ Group (in development) National Hepatitis C MCN Clinical Leads’ Group (in development) National forums  Lead Clinician  “… overall responsibility for the functioning of the Network” HDL(2007)21  Reflect role in Job Plan  MCN Manager / Co-ordinator  Support Lead Clinician  Project management  Effective working relationships: ▪Within MCN ▪Upwards to Health Board ▪Across external organisations  Hep C Executive Lead  Responsible for implementation of Action Plan i.Prevention ii.Testing, treatment, care & support iii.Co-ordination iv.Training, education & awareness raising  Budget-holder  Strategic overview Share information, learning, resources & best practice Avoid duplication of effort Agree national standards National co-ordination & performance monitoring Communication with HPS & Government 2: Management arrangements

6 Care & Support Mental Health Vol. Sector Primary Care Social Care Drug Services Prison Specialist Care Hepatology Infectious Diseases Ultrasound Dietetics Psychology Psychiatry Laboratory Pharmacy Service Mgrs Gastroenterology Testing & Referral Primary Care Prison Inpatients GUM Drug Services Maternity Services Health Board Finance BBV Prevention CHPs Other MCNs Health Improvement Training Public Health Public / Patient Involvement Planning 3: Identify stakeholders  Stakeholders  Strategic or operational?  Internal or external to MCN ?  Actively involved or kept informed?  Patient Involvement  Orgs. that advocate on behalf of people living with & at risk of HCV  Directly with patients & clients  Stakeholder analysis informs:  MCN structure & membership  Communication strategy

7  Identify  Key service providers  Available resources  Patient & information flows  Barriers along journey  Service pressures  Gaps = opportunities for development  Available evidence  Phase II Action Plan  Surveillance data (HPS)  Clinical database  People with HCV  Service providers knowledge  Agree priorities  Inform annual work plan  Proposed developments  Associated investment Care & Support Mental Health Vol. Sector Primary Care Social Care Drug Services Prison Specialist Care Hepatology Infectious Diseases Ultrasound Dietetics Psychology Psychiatry Laboratory Pharmacy Service Mgrs Gastroenterology Testing & Referral Prison Inpatients GUM Drug Services Maternity Services People & information Primary Care 4: Map patient journeys

8 MCN DEVELOPMENT SERVICE DEVELOPMENTS  Communications  Web site  Communication with stakeholder groups  Annual report  Membership & Structure  Bring key stakeholders into process  Subgroups e.g. ▪Prison liaison ▪Outreach testing & referral ▪Public & patient involvement ▪Uni-professional groupings ▪Clinical audit  Quality Assurance  MCN accreditation  Treatment protocol  Clinical audit  Priorities informed by  National Action Plan  Local mapping  Define activities, outputs, & benefits to patients  Develop infrastructure  Clinical staff resources  Outpatient clinic space & locations  Outreach staff & settings  Agreement with partner agencies  Pilot / launch developments  Monitoring arrangements  Activities  Outputs  Outcomes  User satisfaction 5: Annual workplan

9  Used to asses MCN performance  Sound evidence base,  Clinical & care issues,  Relate to the objectives of the MCN,  Clear and measurable,  Follow the patient pathway,  Consistent with those for other hepatitis C MCNs across Scotland.  National standard for hepatitis C services  Phase II Action Plan – Action 2  To be developed by QIS & national MCN Leads Network  Due 2010  Phase II Action Plan accompanied by draft guidelines for hepatitis C MCNs  Inform service standards  National & local 1. Accountability and organisation 2. Policies and procedures 3. Testing 4. Specialist referral 5. Management and treatment 6. Care and support 7. Collaboration and partnership working 8. Patient information and awareness-raising 9. Education and training 10. Monitoring, evaluation and audit 6: Service standards

10  MCN Accreditation  NHS Board accredits local MCNs  Existing process & support  MCN must demonstrate: 1. Plan to implement core principles 2. Service standards developed 3. Monitor implementation of core principles & standards 4. Reporting arrangements in place 5. Process for implementing recommendations  QIS Quality Assurance toolkit*  Overview  Guidance  Templates * Toolkit provided with this presentation 7: Quality assurance

11 MCN Accreditation Timetable: Yrs 1 & 2 Year 1: 2008 Secure stakeholder involvement Secure public / patient involvement NHS Board endorsement Define MCN structure Define patient pathway Agree priorities & key improvement measures Define the MCN communication strategy Assess progress against QIS Quality Assurance model Report progress to Board Year 2: 2009 Define work programme Refine priorities Establish education programme Establish audit and research programme Formal launch Assess progress against QIS Quality Assurance model Report progress to Board 7: Quality assurance

12 RISKS BENEFITS  Lack of corporate buy-in  Threat to clinical autonomy  Resistance to change  Range of organisations with own pressures & priorities  Bureaucracy  Inertia  Organisational capture by dominant partner  Tokenistic user involvement  Integrated patient care across professional & organisational boundaries  Equitable service provision  Reduce duplication of effort & resources  Best use of scarce resources  Innovation  Patient-centred services  Development opportunities for staff Risks and benefits

13 Key messages


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